Individual
MADISON KYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LGSW
Contact information
Practice address
317 N HERITAGE AVE, TEA, SD 57064-2539
(605) 494-1500
Mailing address
PO BOX 33, LARCHWOOD, IA 51241-0033
(712) 209-3897
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
28922
MN
Other
Enumeration date
06/10/2020
Last updated
07/27/2020
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